Heel Pain – Who It Happens To,
Why, And What To Do...

› [Heel Pain]
Pain that is 4 cm forward and medial off the calcaneus is caused by inflamed plantar fascia...

Heel pain is usually a sign and symptom of a condition known as plantar fasciitis...

Plantar Fasciitis comes from a thickening, tearing or wearing down of the plantar fascia…

This tissue is inserted at the heel bone (calcaneal structure) beneath the fat pad that makes your external heel and travels over the length (arch) of the foot to attach at the ball of the foot, just beneath your toes…

Causes Of
Heel Pain…

Rip or strain in the plantar fascia will cause pain that feels sharp...

As in all aches, pains and ailments, there are patterns for causation…

The research shows an overwhelming 80% of people had one or more of these predispositions to plantar fasciitis being the cause of their heel pain…

In non-athletes the causes tend toward...

  • Obesity...
  • Excessive Pronation Of The Foot...
  • Achilles Tendon Tightness...
  • Congenital Bone Deformity (few if any therapies help this situation - the only result may be surgery - but if this is you try what ever you can first - see bottom of this page)...

Not all people who experience these symptoms or situational changes experience plantar fasciitis as a result; its different for everyone when it comes to heel pain...

In Athletes:

  • Change In Running Surface...
  • Change in Foot Wear...

One or many of these situations may be leading to your heel pain…

Plantar fasciitis can also radiate through the toes, and again, depending on how the person is built, can radiate upward to inflict ankle pain as well…

Also, an unknown Talar fracture could lead to an aggravation of the plantar fascia due to the intrinsic muscles of the foot straining to compensate for a loss of stability...

Plantar Fasciitis Occurs More
Often In Females…

The reasons why this is are purely speculative as nobody claims to know exactly why this might be…

The research that I have seen mainly talks about why one thing technique or supplement does not work in relation to this type of heel pain...

So I am going to weigh in with a few possible reasons -

Pregnancy – Sometimes during pregnancy a woman will gain a lot of weight fast…

A couple of ladies I have treated said they woke up fat one day and their feet started to hurt with a sharp pain at the bottom of their heel…

Add to that an old saying before the suffragette movement and civil rights for women – that women should be ‘barefoot and pregnant’…

Whoever made that up ought to be told to have a conversation with me for at least an hour – even though the purveyor of such a saying must by now be dead from illness, natural causes, or perhaps solely by the way of his yapping mouth…

Anyway, during pregnancy, a hypothetical situation may be that a woman will be home from work in her later trimesters, and literally running around, perhaps barefoot, on a hard floor with a lot of extra weight around her pelvic area…

This could bring on a bout of heel pain due to plantar fasciitis if she:

  • Is accustomed to wearing high heels on carpeted floors all day…
  • If her pelvis is other than Gynecoid in shape (women have six different shapes or pelvis)…
  • If, in addition, her pelvis has a rotated or has an abnormal tilt, causing calves to be tight or go weak, therefore causing one or both feet to pronate through the heel strike when she walks or runs…

That particular situation, which I have seen in practice, is breeding ground for long term plantar fasciitis…

Which is why, across the site, I bang on about chiropractic for maintenance care…

Heel pain from plantar fasciitis may occur to sudden weight gain, being home from work out of high heels, or change in pelvic alignment...

Regular adjusting with a method of chiropractic your body likes can and will prevent a lot of these situations…

But anyway, to get back onto topic, and the point I am trying to make here is that each person that comes in with this complaint will have a different set of circumstances and causative factors that has given rise to this condition…

The case evaluation here is critical in order to examine each set of circumstances and correct for them and take the steps to heal your plantar fasciitis; one does not work without the other…

I have read a lot of articles written on the net and I am astounded that the whole body of an individual – movement patterns and so on – are rarely taken into account…

Information is given in a compartmentalized fashion and is therefore given out of context …

Nothing can be decided one way or the other with regard to where your plantar fascia came from if we don’t include how your life integrates with your everyday movement…

At the very least, how the body is moving from the pelvis downward has to be considered before we can get any answers at all as to what forces have damaged the bottom of your feet…

So, women get plantar fasciitis more often…

Aside from pregnancy, there is the question of the shape of a woman’s pelvis to consider as well when we are considering how force is transferring down the thigh, into the knee, down the leg into an ankle and then the finished product of how all of that force is generated into the heel strike and and up through the ball of your foot for push off…

As I mentioned earlier, women have four to six different shapes of pelvis to the one shape men have...

Different pelvic shapes add to the number of variables and probability of women getting plantar fasciitis...
  • So, for women, there are many more variables that transfer into possibility of getting heel pain from plantar fasciitis…

The point I would like to bring home here is that it is important to see someone that will not just treat your foot by telling you to do ice/heat/rest/little rollie ball thingy and massage on the bottom of your foot…

Those things will help, but you also need someone to evaluate your spine, and examine your posture and gait and examine any other areas where there is joint pain

Medicine tries so hard to make everything one size fits all, but this does not work, especially in the area of joint pain…

A good chiropractor who does a thorough case study is going to be more help to you in this case…

Stay away from people trying to sell you supplements, massage things, and online courses – even if they refer to ‘research’ …

Most of the time these are people who spend their time gathering information, manipulating it to package it; having never treated anyone in their lives...

What To Do And How Long
This Is Going To Take…

The first measures should be conservative ones…

  • R est – feet up and as little weight bearing as possible...
  • Ice – In the early acute stages a gel pack or bag of frozen peas 10-15minutes...
  • Compression – you tape for support...
  • Elevation – put your foot up above your heart…

Exercises are the 2nd line of fire after your foot has calmed down and is sore but you are no longer in acute pain…

exercise to strengthen the intrinsic muscles of the foot and correct any imbalances…

For this  I will recommend The Stone Clinic…

The link below will provide a video of one very effective exercise for plantar fasciitis (dont worry if you are not a runner, do them anyway!)

If you look through the site, or enter plantar fasciitis into the sites search bar, you will find several more, but start with this one...

http://www.stoneclinic.com/video/Foot-Ankle-Exercise-Towel-Toe-Curls

These guys are great and I really recommend going through and finding everything you need…

This includes exercises and treatment for ankle pain as well which may accompany plantar fasciitis...

Just to help you gain perspective, it is normal for heel pain due to plantar fasciitis to take about a year to completely heal…

If You Are 6 Months On
And Still In Pain…

Extra-corporeal shock wave therapy, or ESWT, has emerged as a possible treatment option for people with plantar fasciitis....

If you are six months down the road and still experiencing debilitating heel pain you may need to take more extreme measures…

You may need to get an Ultra-sound to view the thickening of the plantar fascia and fluid collection…

In this case ESWT (extra-corporeal shock wave therapy) may be needed to redistribute tissue and help the body re-absorb the fluid. It is essential this is done because with tissue exposed to an excess of fluid long term you can get a degenerative, avascular necrotic effect – there could be rotting tissue under your skin eventually…

  • Steroid Injections

These are good for temporary relief but keep in mind one thing- they do not promote healing…

The newest thing:

  • Platelet Rich Plasma Injection…

I have a lot of hope for this technique as there is recent literature supporting its efficacy…

This involves an injection of your own blood platelets which produce a healing rate…

Click below to view the abstract:

https://www.ncbi.nlm.nih.gov/pubmed/20398269/

  • Surgery

And the final alternative is surgery, but this is really a final and last option…

Unless everything else has been tried, please do not consider surgery...

This involves cutting part of the plantar fascia to relieve tension, and it will forever altar your gait; so consider it the final frontier...

Summary...

Plantar Fasciitis will present as cutting pain in heel...

Worse in the morning, then fading away in the day, and then returns with more intensity as the day goes on...

Left untreated it could turn into a condition that causes you not to be able to live your life…

Before going beyond basic treatment, make sure you have been evaluated for posture and gait and do not accept someone just telling you they have a great technique or product that can help you…

Plantar Fasciitis is something that many chiropractors treat; but you may have to take a look around…

New techniques such as PRP are being used, and it is worth your while to try such a technique and even travel to do so before resorting to surgery...

› [Heel Pain]

Disclaimer – This is information on joint pain. I teach, but I do not diagnose, prescibe or treat people who contact me. You are responsible for your condition using your own best judgement combined with what you have learned. Just a heads up - bodies carry unusual differences from time to time, in saying that, you could be one of those rare and unusual beings; if you are in doubt, please contact a physician in your area, so you can rule it out.

Move Freely and Knowledgeably and Be Well!

Dr. Jo

P.S...    “Greater certainty of your condition alone can be a powerful form of pain relief.”